Applied Rationality focuses on public policy issues and tries to take a liberal perspective that is consistent (comments to the posts will often show otherwise) with neoclassical, rational-choice economics.

Thursday, December 13, 2012

NC Republicans' latest prescription for higher health care costs

North Carolina Republicans latest contribution to spriraling health care costs is ... a proposal to drive up costs some more.

A legislative panel on Wednesday
suggested requiring a prescription for cold remedies containing one of
the main ingredients used to make methamphetamine.

Lawmakers in
2005 ordered North Carolina pharmacies to put medicines containing
pseudoephedrine behind the counter to make it more difficult for people
to use them to cook up meth. Last year, pharmacists began entering
customer names into a national database when they buy the medicines to
alert them to anyone buying large quantities of the drug.

The
changes have done little to stem the proliferation of home labs that
produce meth, a potent stimulant that can be made with over-the-counter
household products, often leaving behind a toxic mess.

According
to the State Bureau of Investigation, law enforcement has busted a
record 444 labs statewide so far this year – 100 more than the previous
record, set in 2011. Wilkes County, in the mountains in the northwest
part of the state, has had the most busts this year at 58, followed by
Wayne County in the east at 27.

Each time one of these laws is passed, lawmakers confidently promise the same thing--that this new restriction will turn the tide against meth labs. And each time they are proven wrong. Such an unbroken record of failure should instill some humility or perhaps some consideration of other approaches; instead it only emboldens the drug crusaders and begets more restrictions.

And indeed, proponents are once again saying that this time will be different.

So far only two states--Oregon and Mississippi--have had enough disregard for the well-being of their law-abiding citizens to enact prescription requirements for cold medications. WRAL cites figures that show dramatic decreases in meth lab busts in those states following the enactment of the laws. It later quotes Rep. Rep. Craig Horn, chairman of the House Select Committee on Methamphetamine Abuse, who asks, "Do we just have to have more dead bodies? Or are we going to do something when we know there's an action that works?"

So what exactly do we know? Examinations of those data suggest--not a whole lot.

An analysis earlier this year of the Oregon figures by the Cascade Policy Institute found that nearly all of the drop in meth lab busts occurred before that state's laws took effect and that California and Washington, which didn't enact prescription laws, saw nearly the same percentage drops in meth lab busts.

A look at the Mississippi experience isn't any more encouraging. In 2009, the year that Mississippi enacted its prescription law, the DEA reported 691 meth lab "incidents" in the state; two years later, the DEA reported that the number of incidents fell to 259. The numbers look impressive until you consider that in neighboring Alabama, meth lab incidents fell even more from 614 in 2009 to 177 in 2011. Over the same period, meth lab incidents in Louisiana fell from 80 to 36. Perhaps more disquieting, the DEA figures also indicate that meth incidents in Mississippi actually increased in the intervening year, rising to 698 in 2010.

While it is difficult to demonstrate the benefits of these laws, we do know the costs. The laws that moved cold medicines "behind the counter" inconvenienced millions of sick people and increased costs for all pharmacies. The most recent law in North Carolina, requiring the registration of all cold medicine purchases, increased costs further and created a massive invasion of privacy.

The proposed restrictions would go even further. Monetary costs would go up even more--either through doctor's fees, insurance copayments, or the cost to insurers. Time costs would also increase. Cold medicine might be out of reach for the poor and uninsured who can't afford a doctor. Costs for drug stores would also rise, as pharmacists have to read and process prescriptions. These are non-trivial costs. Worse, they are repeated over and over for all law-abiding North Carolinians.